Spontaneous hypothermia on intensive care unit admission is a predictor of unfavorable neurological outcome in patients after resuscitation an observational cohort study 英文参考文献.docVIP

den Hartog et al. Critical Care 2010, 14:R121 /content/14/3/R121 RESEARCH Open Access Spontaneous hypothermia on intensive care unit Research admission is a predictor of unfavorable neurological outcome in patients after resuscitation: an observational cohort study Alexander W den Hartog1, Anne-Cornélie JM de Pont*1, Laure BM Robillard1, Jan M Binnekade1, Marcus J Schultz2 and Janneke Horn1 Abstract Introduction: A large number of patients resuscitated for primary cardiac arrest arrive in the intensive care unit (ICU) with a body temperature 35.0°C. The aim of this observational cohort study was to determine the association between ICU admission temperature and neurological outcome in this patient group. Methods: Demographics and parameters influencing neurological outcome were retrieved from the charts of all patients resuscitated for primary cardiac arrest and treated with induced mild hypothermia in our ICU from January 2006 until January 2008. Patients were divided into two groups according to their body temperature on ICU admission: a hypothermia group ( 35.0°C) and a non-hypothermia group (≥35.0°C). Neurological outcome after six months was assessed by means of the Glasgow Outcome Score (GOS), with GOS 1 to 3 defined as unfavorable and GOS 4 to 5 as favorable. A logistic regression model was used to analyze the influence of the different parameters on neurological outcome. Results: The data of 105 consecutive patients resuscitated for primary cardiac arrest and treated with induced mild hypothermia were analyzed. Median ICU admission temperature was 35.1°C (interquartile range (IQR) 34.3 to 35.7). After six months, 61% of the patients had an unfavorable outcome (59% died and 2% were severely disabled), whereas 39% had a favorable outcome (moderate disability or good recovery). Among patients with spontaneous hypothermia on ICU admission, the percentage with unfavorable outcome was higher (69% versus 50%, P = 0.05). Logistic regression showed